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Best MRCS part A anatomy

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These notes include high yield anatomy information taken from Pastest, eMRCS, and various notebooks. Guaranteed higher grades and easily answer any anatomy question.

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  • January 17, 2021
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Anatomy



The testes share T10 innervation with the ureter and the umbilicus, which is why
testicular pain can often be felt in the abdomen and ureteric colic is sometimes
accompanied by perception of pain in the testes.
The ureter is not related to the round ligament of the uterus, it is related to the
broad ligament and is within 1.5cm of the supravaginal part of the cervix.
The portal vein lies behind the hepatic artery proper and bile duct. Formed by the convergence of
the superior mesenteric vein and the splenic vein. The portal vein typically measures 8 cm in length
and is formed by the convergence of the superior mesenteric vein and the splenic vein. It lies in front
of the IVC and lies behind the pancreas and the first part of the duodenum.
The inferior mesenteric vein drains into the splenic vein, this point of union lies close to the
duodenum and this surgical maneouvre is a recognised cause of ileus




The short gastric arteries are branches of the splenic artery and course in the gastrosplenic
ligament, which connects the greater curve of the stomach to the hilum of the spleen. It also contains
the left gastroepiploic vessels

,The pudendal nerve is formed by the ventral rami of the sacral spinal nerves from S2, S3 and S4. It
maintains voluntary urinary continence by facilitating contraction of the external urethral sphincter.
Damage to this nerve could result in urinary or fecal incontinence. Cyclists may develop pudendal
nerve entrapment syndrome (also known as Alcock canal syndrome)

The inner cheek mucosa is supplied by the buccal branch of the anterior division of the
mandibular branch of the trigeminal nerve - the only sensory branch of the anterior division.

The lienorenal ligament connects the hilum of the spleen to the left kidney. The splenic artery and
vein are carried within it, as is the pancreatic tail.
Most of the gut is derived endodermally except for the spleen which is from mesenchymal tissue

The superficial fibular (peroneal) nerve supplies the peroneus longs and breves muscles, and
sensation to the skin over the greater part of the dorsum of the foot, except the first webspace (which
is supplied by the deep peroneal nerve). Deep fibular innervates the anterior compartment of the
leg.
The common peroneal nerve lies under the lateral aspect of biceps femoris and is therefore at
greatest risk of injury. The tibial nerve may also be damaged in such an injury. The sural nerve
branches off more inferiorly.

,The foramen spinosum (which transmits the middle meningeal artery and vein) lies in the
sphenoid bone.

Foramina:




The glossopharyngeal nerve innervates the tonsillar fossa. It also gives a sensory branch to the ear
(Jacobsen’s nerve) from which referred pain can originate.

RCA branches from the aorta at the coronary cusp and travels anterograde-inferiorly in the right
atrioventricular groove.
The right coronary artery supplies the AV node in around 85-90% of people, via the AV nodal branch
(a branch of the posterior inter ventricular artery).
The RCA supplies:

• Right atrium
• Diaphragmatic part of the right ventricle

, • Usually the posterior third of the interventricular septum
• The sino atrial node (60% cases)
• The atrio ventricular node (80% cases)

The LCA supplies:

• Left atrium
• Most of left ventricle
• Part of the right ventricle
• Anterior two thirds of the inter ventricular septum
• The sino atrial node (remaining 40% cases)


The cervical pleura is also known as the dome or the cupola.

The transverse cervical artery is a branch of the thyrocervical trunk (from the first part of the
subclavian artery). It gives off the superficial cervical artery and usually the deeper dorsal
scapular artery (supplies elevator scapulas and the rhomboids). The dorsal scapular artery can
also branch directly from the third part of the axillary artery.
The posterior circumflex humeral vessels which are branches of the axillary artery are related to
the axillary nerve within the quadrangular space.
The quadrangular space is bordered by the humerus laterally, subscapularis and teres minor
superiorly, teres major inferiorly and the long head of triceps medially. It lies lateral to the
triangular space. It transmits the axillary nerve and posterior circumflex humeral artery
The dorsal scapular nerve is a motor nerve from the C5 nerve root directly that innervates the
rhomboids and levator scapulas. These muscles help to retract and elevate the scapula, so these
movements would be weakened following the damage.
Shoulder extension is chiefly via the latissimus dorsi, innervated by the thoracodorsal nerve and also
via the teres minor (axillary nerve) and the teres major (lower sub scapular nerve)


The vagus nerve (CN X) innervates a variety of abdominal viscera and stimulates activity via
parasympathetic activity.

The gastroduodenal artery is a branch of the common hepatic artery. It passes posteriorly to D1
before bifurcating into the right gastroepiploic and superior pancreaticoduodenal arteries. A
duodenal ulcer in the posterior wall of D1 could therefore erode into it, causing an upper GI
hemorrhage.
The gastroduodenal artery divides into the gastro-epiploic and pancreaticoduodenal arteries at
the superior aspect of the pancreas.

The superficial inguinal lymph nodes primarily drain the external genitalia of the male

The septum transversum is a thick ridge of mesodermal tissue in the developing embryo that
separates the thoracic and abdominal cavities and forms the central tendon of the diaphragm

Muscles supplied by the median nerve LOAF: lateral two lumbricals, opponens pollicis, abductor
pollicis brevis, flexor polices brevis.
Loss of median nerve will result in loss of function of flexor muscles. However, flexor carpi ulnaris
will still function and produce ulnar deviation and some residual wrist flexion. High median nerve
lesions results in complete loss of flexion at the thumb joint.
The median nerve may be injured proximal to the flexor retinaculum. This will result in loss
of abductor pollicis brevis, flexor pollicis brevis, opponens pollicis and the first and second

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